SANDRA ELAINE ODOM (NPI# 1669933370) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669933370 |
| Entity Type | Individual |
| Full Name | SANDRA ELAINE ODOM |
| Other Name | SANDRA PATTON |
| Practice Address |
220 N 19th St Van Buren AR 72956-4710 |
| Practice Telephone | 4793300159 |
| Mailing Telephone | 4793300159 |
| Enumeration Date | 2019-03-26 |
| Last Update Date | 2019-03-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | A006138 | AR | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
A006138 | AR | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
A006138 | AR | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
220 N 19TH ST |
| City | VAN BUREN |
| State | AR |
| Zip Code | 72956-4710 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760092597 | Fort Smith Regional Dialysis Center, LLC | Clinic/Center | 256 Northridge Drive E, Van Buren, AR 72956 | 2020-08-06 |
| 1831678507 | Baptist Health Services | Family Medicine | 209 Pointer Trl W Ste A, Van Buren, AR 72956 | 2018-08-13 |
| 1235618992 | Baptist Health Services | Pediatrics | 209 Pointer Trl W Ste B, Van Buren, AR 72956 | 2018-08-13 |
| 1225517030 | Baptist Heath Services | Family Medicine | 14 Gothic Ridge Rd Ste B, Van Buren, AR 72956 | 2018-08-13 |
| 1255810206 | Baptist Health Services | Family Medicine | 14 Gothic Ridge Rd Ste A, Van Buren, AR 72956 | 2018-08-10 |
| 1407371339 | Allison Frazier | Speech-Language Pathologist | 2221 Pointer Trail East, Van Buren, AR 72956 | 2017-08-11 |
| 1225443104 | Arkansas Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 2015 Fayetteville Road, Van Buren, AR 72956 | 2014-06-30 |
| 1629326210 | Natalie N. Fink | Speech-Language Pathologist | 1109 Fayetteville Rd., Van Buren, AR 72956 | 2012-08-29 |
| 1538490271 | Ronald Joel Yukon | Chiropractor | 2731 Rudy Road, Van Buren, AR 72956 | 2010-01-20 |
| 1568799864 | Fritzie Suggs | Occupational Therapist | 2233 Alma Hwy, Suite C, Van Buren, AR 72956 | 2009-11-06 |
| Find all providers in zip 72956 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235327636 | Van Buren Medical Center of Mgc | Nurse Practitioner | 201 N 1st Street, Van Buren, IN 49661 | 2007-10-10 |
| 1508803123 | Katherine Alice Swenson | Nurse Practitioner | 402 Main St., Van Buren, MO 63965-0486 | 2006-06-01 |
| 1922508845 | Crystal Hurst | Nurse Practitioner | 30 Northridge Dr, Van Buren, AR 72956-6668 | 2018-02-16 |
| 1043766355 | Rebecca Compton | Nurse Practitioner | 405 Main St, Van Buren, MO 63965-9719 | 2016-08-28 |
| 1598113375 | Julie Raymond | Nurse Practitioner | 4 Main St, Van Buren, ME 04785-1009 | 2016-06-02 |
| 1275932253 | Monique Thammavong | Nurse Practitioner | 14 Gothic Ridge Rd, Van Buren, AR 72956-6565 | 2014-08-15 |
| 1811319783 | Danielle Yvonne Weaver | Nurse Practitioner | 109 Pointer Trl W, Van Buren, AR 72956-2236 | 2014-01-13 |
| 1831443696 | Bb Chiropractic Inc | Nurse Practitioner | 623 Fayetteville Rd, Van Buren, AR 72956-3418 | 2012-11-01 |
| 1275781254 | Michelle E Burnham | Nurse Practitioner | 402 Main St, Van Buren, MO 63965-0000 | 2008-09-03 |
| 1457544934 | Stephanie Ann Davis | Nurse Practitioner | 620 Broadway St, Van Buren, AR 72956-5830 | 2007-08-20 |
| Find all providers in VAN BUREN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.